Urgent help needed; Klonopin has ceased working, just RX'd Xanax instead, need advice

[treadlightly]

I need info quickly/urgently about Xanax (and to a lesser extent Klonopin) and how much I should take to be effective at combating severe anxiety without putting me into a coma or anything...I have SERIOUS obligations both tonight, tomorrow and the next day and my extreme anxiety is currently preventing me from meeting those obligations. I was just prescribed Xanax today and I'm trying to figure out how much to take, but before I go on I think it's very important to know my history with benzodiazepines...I know it's long (sorry), but I believe it definitely plays a role here:

SITUATION/SUMMARY: Was prescribed Klonopin (1MG) about 4 years ago in 2010 to take *as needed* for anxiety - took it sparingly for the first 3.5 years, only when I really needed it (once or twice a month) and 1MG was enough to eliminate the anxiety every time. I once tried 3MG back then and it made me black out.

Latter half of 2013 I began to take it more frequently as my anxiety was becoming slightly more severe but still only maybe once or twice a week - I actually made a Word document with a log every time I took it, how much, and how it impacted my anxiety so I know exactly how much I took. I was still taking the same dosage (1mg or 1.5mg), but maybe 3-5 times a month - this continued up until February of this year.

Then comes 2014, particularly February onward, and my anxiety spikes WAY higher than ever before; my depression gets much worse as well but that's not what I'm posting about. There were no med changes, no events, nothing I know of that precipitated this...just all of a sudden, my mental/emotional health became much worse. So, with increased stress and anxiety I began taking the Klonopin more frequently. I would always purposely not eat so that I'd take it on an empty stomach so it would be more effective...and many times I wouldn't eat anything for the rest of the day in fear of food diminishing the anxiolytic effects of the Klonopin. I increased the frequency to maybe 3 times a week at first. I noticed that the 1 or 1.5mg doses weren't working against my MUCH elevated anxiety so I upped the dose to 2mg or 2.5mg. Then when even that didn't work, out of desperation I tried mixing it with alcohol...mostly hard liquor, shots of vodka etc. I am still a lightweight when it comes to alcohol and when alcohol was involved it usually did not end well and only occasionally improved things/alleviated my anxiety...maybe 15% success rate. I didn't drink with it EVERY time, but from this point on maybe like 1/3rd of the time I took Klonopin for anxiety alcohol would be involved by the end of the night.

LATE FEB-MID MARCH 2014: So then at the end of February/the beginning of last month, March, my mental/emotional state deteriorated further...I stopped bothering with logs for the most part. From late February to mid March I took the Klonopin with about the same frequency, maybe 3 or 4 days a week, and took 3MG every time which was sometimes effective, sometimes not. In mid March I took 4MG, my max ever dose, and after hours with not nearly enough anxiety relief I added in alcohol to the mix and of course blacked out. It's probably worth mentioning that I live totally alone and any time I've drank anything with the Klonopin in my system (and as mentioned above, nothing else, almost always on an empty stomach) I have been alone at home. I should also mention at this point that I am a 26 year old male, 5 foot 7 and weigh 123 pounds.

PAST MONTH (mid/late March to now, April 16th)
After the 4mg dose with the booze and no relief I knew it was time to see a doctor about the meds (and had actually been trying for months) but my doctor had no availability until the beginning of May and every other pdoc wasn't accepting new patients or didn't take my insurance. Started taking some higher doses like 5.5MG or 6MG, although not all at once...spaced out throughout the day when I kept having anxiety so I added more. I kept brief logs of this. 4MG was what I usually took at this point, although I think I cut back on the frequency a bit (twice a week or so).
Sometimes it would help, sometimes it wouldn't. When it wouldn't I would add booze to the mix, rarely with positive results. Last day of March I started out with 5MG all at once since I knew I had a majorly anxiety-provoking and stressful day ahead of me...5MG wasn't enough so I took another 1MG a few hours later, then that still wasn't enough so 2 hours later I took another 1MG, then 3 hours later the anxiety still hadn't subsided so I took another 1MG, bringing me to my grand total of 8MG Klonopin for the day...and then added booze into the mix. According to what I wrote in my diary, it was only at this point that my anxiety finally reached a manageable level.

My diary is missing entries from a lot of days since March 30th, 2014 but I know I upped the frequency of the Klonopin again and 5MG was my new minimum and usually did not work. I have an entry dated 4/13/2014 (3 days ago) saying "UGH it has been 3 hours since I took 7mg kpin all at once and everything is practically the same, anxiety just as bad. 7mg kpin on no food and NOTHING in terms of anxiety relief."
(END OF SITUATION/SUMMARY)

So basically that's where I'm at now. First of all, I learned my lesson and have cut alcohol out of my life entirely. But 7MG of Klonopin taken all at once doesn't do anything for me and I still need immediate anxiety relief for extreme situations, and badly. I have real-world obligations, serious ones, and my anxiety is severe enough to prevent me from doing them no matter how important I know they are.

I finally saw a doctor today, told her the Klonopin had stopped working for my anxiety even at high doses, and she prescribed me 0.5mg Xanax instead. I have never taken Xanax before today. I took the first 0.5mg Xanax 2 hrs and 40 minutes ago, felt no different after an hour and a half, and took another 0.5mg Xanax 1 hour and 10 minutes ago...and still feel zero anxiety relief.

Questions: Xanax is not Klonopin, but they're similar. Does the fact that 7MG of Klonopin has zero effect on my anxiety mean that the Xanax will be equally ineffective? Is the same dose of Xanax equivalent in potency/efficacy to the same dose of Klonopin, keeping in mind I've never taken Xanax before? Can I mix the two together? I feel like 0.5mg is *way* too low of a dose and am more convinced of that now that 1mg has proven to do nothing but then again I don't know that much about Xanax. Can I safely take, for instance, 4mg of Xanax without major repercussions (keeping in mind my tolerance to Klonopin and the severity of my anxiety)? Or 2mg Klonopin and 3mg Xanax or something like that? How likely is it, given this info, that I am essentially screwed in terms of any benzos ever working for me again?

Like I said, I have HUGELY important obligations to meet both tonight, tomorrow and the next day and my anxiety is currently ruining tonight's and I can't afford to let my anxiety ruin the others as well...so any advice would be GREATLY appreciated. Sorry for the length, but I felt including all the details was important and hopefully some kind soul will see this and be able to offer some help or information. Thank you for your time.

P.S. I have been prescribed and tried almost every other medication under the sun over the last 14 years, seen 20+ different doctors for my anxiety in that time span, and absolutely none of the meds have gotten rid of my anxiety except for the Klonopin...which is now ineffective. SSRIs, SNRIs, Tricyclics, Stimulants, Anti-Psychotics and several other classes of medication I'm forgetting. Non-med routes as well...15+ different therapists, CBT, exposure therapy, aromatherapy, meditation, almost everything. Nothing else works, which is why I'm so desperate.

[Keaton]

I feel your pain. I don't even take klonopin, xanax, etc, because they don't seem to work for me. I'm glad that I don't really need them.

 

I know this isn't what you want to hear, but I would not recommend going over what has been prescribed. That's hypocritical of me because in the past I've taken two sleeping pills rather than one in the same night, but seriously, be careful. Get in to see a doctor as soon as possible if this dosage is not helping you at all, but don't just start taking more and more Xanax. Even call your doctor if you need to.

 

Klonopin has a longer half-life than Xanax, I believe. Other than that I don't think they're terribly different. But the Xanax will probably feel as though it has more of an "edge" if you've never taken it before.

 

Is your problem getting to sleep and sleeping well? Or is it just really bad anxiety when you're awake? Or both?

 

edit: you might find this useful:

 

http://www.medscape.com/content/2003/00/45/67/456734/456734_tab.html

Edited April 17, 2014 by Keaton

[quiet storm]

Not trying to be funny or mean here....but you are a HOT MESS. You have been on some seriously high dosages of klonopin with no relief in anxiety. I'm not a doc but I don't know why you were prescribed Xanax when a 7mg dose of klonopin does nothing for you. The only advantage of Xanax is it's quicker acting. That's really about it. The half life is MUCH shorter than klonopin which is definitely not what somebody with your condition needs.

You need to somehow get into to see a real psychiatrist and address your serious problems. It's obvious that benzos alone are not going to help you and need to get a better treatment plan. And you need to stop drinking with benzos. Seriously, quit doing that.

[MisterJoshua]

And really seriously think about doing DBT. It can do huge things for anxiety. If you've done it before, go get a refresher. I know this won't help you tomorrow, but you can't sustain this level of benzo use/abuse for the long term

[melissaw72]

What is the dose your DR prescribed for the xanax (sorry if I missed it in your post)?

 

 

Xanax is not Klonopin, but they're similar. Does the fact that 7MG of Klonopin has zero effect on my anxiety mean that the Xanax will be equally ineffective? Is the same dose of Xanax equivalent in potency/efficacy to the same dose of Klonopin, keeping in mind I've never taken Xanax before? Can I mix the two together?

 

Taking 7 mg of Klonopin having zero effect does not mean the xanax will do the same.  I don't think that the same dose of Klonopin = same dose of xanax (someone please correct me if I am wrong).  Xanax is shorter acting but acts right away, as oppsed to klonopin which is usually (at least for me) used to maintain anxiety because it is longer-acting.

 

Yes, you can take them together.  I take klonopin in AM and PM, and xanax as needed during the day for breakthrough anxiety.

[MiaB]

There is so much that's concerning about your post that I'm not sure where to begin.  Perhaps I'm misunderstanding what you wrote, but it sounds like you've had access to an apparently bottomless supply of klonopin for some time and have been dosing yourself at random without consulting a doctor.  I won't ask where you got the klonopin from, but doing what you've been doing without professional assistance is a really, really bad idea.  I know the "speak to your doctor" line can be annoying to hear, and some people think we trot it out too much on CB, but seriously, you have to get honest with a psychiatrist and work with him/her.  And that's one psychiatrist, because saying that you've seen 20+ in the space of 14 years sounds an awful lot like doctor shopping.  I very much hope I'm wrong in that assumption, because I was in that position a long time ago, and trust me on this, it goes nowhere good.

 

I finally saw a doctor today, told her the Klonopin had stopped working for my anxiety even at high doses, and she prescribed me 0.5mg Xanax instead. 

 

 

Did you tell the doctor what you meant by "high doses"?  That you went up to 7mg and you were drinking on top of it?  Because I agree with quiet storm in wondering why you were prescribed a low dose of Xanax, given what you'd been doing to yourself.

 

Is the same dose of Xanax equivalent in potency/efficacy to the same dose of Klonopin, keeping in mind I've never taken Xanax before? Can I mix the two together? I feel like 0.5mg is *way* too low of a dose and am more convinced of that now that 1mg has proven to do nothing but then again I don't know that much about Xanax. Can I safely take, for instance, 4mg of Xanax without major repercussions (keeping in mind my tolerance to Klonopin and the severity of my anxiety)? Or 2mg Klonopin and 3mg Xanax or something like that? How likely is it, given this info, that I am essentially screwed in terms of any benzos ever working for me again?

 

 

You're asking us, a group of random strangers on the internet, to make prescribing recommendations for you.  Firstly, we can't and don't do that (and we don't cross that line even if you do have massive obligations to meet) and secondly, this is really reckless behaviour.  You're not treating yourself well or respectfully.  I'm very sorry that you have gotten yourself into this position and that your anxiety is so out of control (I mean that - I'm not some holier-than-thou asshole; I have done my own fair share of not very clever things), but you have got to take all this to a psychiatrist and lay it all out exactly as you did for us.  And judging from what you've said, you have to do that sooner rather than later.

Edited April 17, 2014 by miab
clarity

[mellifluous]

i'm so sorry this is happening with you; i hope you seek professional medical advice immediately. 

 

you could show your post to a psychiatrist and that would probably go a long way to you getting some relief.

 

take care and welcome

Edited April 17, 2014 by mellifluous

[Wooster]

Please don't drink with your benzos. There's something called the "synergistic effect" that makes the effects more than 1+1. It's a good way to accidentally end up rock-star dead.

You also probably won't like what I'm about to say...

If you have had 20 doctors and 15 therapists in 14 years, that's a lot. Stop doctor and therapist shopping. Find ONE pdoc and ONE tdoc that you like. Stick with them and WORK OUT problems that you have with your treatment WITH THOSE PROVIDERS.

[Siggmin]

Don't take more Xanax than your doctor prescribed you. It's never a good idea to take more of a med than what's prescribed to you. I was on Ativan a few years ago, and my doctor warned me that even a little more than what was prescribed could kill me. Not saying that's always the case, but that's what I was warned. It can be dangerous. Have you tried Saphris? It's a fairly new antipsychotic, and I'm prescribed it for psychosis, but I find it helps my anxiety as well.

[melissaw72]

How are things going?

[quiet storm]

Don't take more Xanax than your doctor prescribed you. It's never a good idea to take more of a med than what's prescribed to you. I was on Ativan a few years ago, and my doctor warned me that even a little more than what was prescribed could kill me. Not saying that's always the case, but that's what I was warned. It can be dangerous. Have you tried Saphris? It's a fairly new antipsychotic, and I'm prescribed it for psychosis, but I find it helps my anxiety as well.

 

It's nearly impossible to kill yourself with benzo's alone. Now drinking while taking benzo's....or mixing with something like opiates......yeah makes it quite a bit easier.

Edited April 21, 2014 by quiet storm

[Siggmin]

Don't take more Xanax than your doctor prescribed you. It's never a good idea to take more of a med than what's prescribed to you. I was on Ativan a few years ago, and my doctor warned me that even a little more than what was prescribed could kill me. Not saying that's always the case, but that's what I was warned. It can be dangerous. Have you tried Saphris? It's a fairly new antipsychotic, and I'm prescribed it for psychosis, but I find it helps my anxiety as well.

 

It's nearly impossible to kill yourself with benzo's alone. Now drinking while taking benzo's....or mixing with something like opiates......yeah makes it quite a bit easier. That doctor was a quack, so you're probably right. I think he just wanted to scare me. But that's what I was told.